All posts tagged Health Policy

Rather like a broken record, I have been warning for years that historically low rates of increase in health-care spending would not last. Now it’s time for a different warning: The higher rates of growth now expected are moderate and should be seen in context. Media outlets–especially headline writers–should take care not to dramatize them.

The chart above shows why. Whatever the wishful thinking, the slowed rates of 2008 to 2013 did not represent a watershed period when we had some secret formula for controlling growth in health spending; they were an aberration. Spending grew by an average annual per capita rate of 3.1% during that period, compared with much higher rates in the past and a projected 4.9% average growth rate for 2014 to 2024. But the projected 2014-24 growth rate is moderate by historical standards, and a bounce back to the higher growth rates of the past is unlikely given the many changes in the marketplace and in public programs aimed at restraining costs and producing greater value per health-care dollar. Read More »

Many Americans are skeptical about foreign aid because they believe a large share of U.S. assistance is lost to corruption. When it comes to global health, as the chart above shows, 83% of Americans say corruption and misuse of funds is a barrier to improving health in developing nations, and 43% say it is the most important barrier. Corruption is a problem. World Bank President Jim Kim has called it “public enemy number one.”

When an employer pays a worker in cash, the worker has to pay income and payroll taxes on the money. When an employer provides or subsidizes health insurance, the worker doesn’t pay taxes on the benefit. This practice, which dates to World War II-era wage-and-price controls, encourages employers to offer more generous health insurance plans as opposed to paying higher wages. It’s one of several reasons the U.S. spends so much more on health care than other rich countries. Read More »

Debate about the Iran nuclear deal shows that issues besides the Affordable Care Act can suck up partisan oxygen, at least for a time. But the respite for the ACA is likely to be fairly short-lived.

As the chart above shows, initial Republican reaction to the Iran deal, though leaning negative, is not as negative as sentiments toward the health-care law. The Affordable Care Act escaped a political and policy crisis last month when the Supreme Court ruled for the government in King v. Burwell–and the ACA may catch a second break if conservative ire focuses on the Iran deal for the immediate future. But the health-care law is not likely to disappear for long as a political issue, and the politics of the ACA are not likely to change significantly until after the next election cycle. Consider: Read More »

In the wake of the Supreme Court’s King v. Burwellruling, some have argued that a more bipartisan approach to health policy may emerge. But fundamental philosophical disagreements between liberals and conservatives suggest that rapprochement will be difficult.

Philosophical disagreements played into in the debate over pre-Obamacare health coverage. Many conservatives argued that people should be allowed to keep their plans (as the president originally promised). Most also want to liberalize the ACA’s definition of “insurance.” That involves widening the age rating bands—older people will pay a little more, so younger people can buy cheaper policies—and eliminating some benefit requirements so that, to use a frequently cited example, single men don’t have to purchase pregnancy coverage and retired couples don’t have to buy plans that cover well-baby visits. Read More »

Shortly after the ACA ruling was announced, Hillary Clinton‘s 2016 campaign sent out a fundraising email, warning Americans that “Republicans running for president still want to take basic health security away from millions of Americans.” Jeb Bush’s campaign solicited contributions about as quickly, warning that the president “forced ObamaCare on the American people in a partisan and toxic way” and that “we both know that Hillary Clinton will be more of the same.” There’s a message implicit in these e-mails: It may be only a brief time before the Affordable Care Act heats up again as an issue in the 2016 election cycle. That doesn’t mean it will move a lot of votes, but it will generate heat and could affect turnout at the margins. Read More »

Speaking in the Rose Garden, Mr. Obama said that after legal challenges and repeal efforts, the health-care law was working as intended after surviving numerous challenges before, during and after its passage. Read More »

The ACA will, however, continue to be an issue in the run-up to the 2016 elections. Republicans in particular are likely to use the issue to rev up their base in hopes of increasing turnout in an election many think will hinge more on turnout than on efforts to move the increasingly small number of true independents. Read More »

There has been a lot of discussion about the political implications for Republicans if the Supreme Court rules for the plaintiffs in King v. Burwell, disallowing federal insurance subsidies for about 6 million people in 34 states with federally operated insurance exchanges. One scenario is that Republicans will agree on a clean fix, adjusting the legislative language to allow subsidies to continue to be provided; or there will be a fix that the president can sign with some modest concession to the right. Another scenario is that Republican hard-liners and moderates will be unable to agree on legislation and states will be left to decide on their own whether to set up marketplaces, a process that will take time to unfold.

We are unlikely to know how this will play out until the court issues its ruling and Republicans in Congress and the states see how intense the political pressure is to fix the problem. That heat will not be one-sided. Read More »

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